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Subang, Malaysia, 6th November — With an estimated 930,000 new HIV infections in Asia and Pacific in 2005, UN agencies have called for urgent efforts to better integrate HIV prevention, treatment and care into maternal and newborn health services to prevent the escalating spread of the virus and reduce mortality. Calls for strengthening integration of these vital health services came at the opening of the first Asia Pacific Joint Forum in Malaysia.

With sixty per cent of the world’s population living in this region and many countries with a high proportion of young people between the ages of 15 and 25, the need to scale up HIV prevention, treatment and care efforts and provide better reproductive health services, is urgent. Due to inadequate maternal and child health services, many countries also suffer from high maternal and infant mortality, especially during a child’s first month of life.

Globally, as part of the Millennium Development Goals, Governments have agreed to reduce maternal mortality, tackle infant and child mortality, and to prevent the further spread of HIV and AIDS. In October 2006, the United Nations General Assembly endorsed a new target for universal access to reproductive health by 2015.

Yet in many countries, public health budgets remain low, access to health services, especially in rural areas, remains inadequate, and pervasive gender inequality and discrimination continues to hamper efforts to roll out HIV prevention, treatment and care, and also scale up access to maternal and child health services.

The World Health Organization noted that in many countries, efforts to scale up prevention of parent to child transmission and roll out access to HIV treatment are underway. However, this can only succeed if we better strengthen our investment in the primary health care system, especially to improve outreach and referral services to those who are most in need.

Although patterns of HIV infection vary greatly between and within countries in the region, there has been a rapid increase among people with high-risk behaviors, who are often poor, marginalized and increasingly women. Between 2001 and 2004, the estimated number of HIV positive women in the region increased by 16 per cent to over two million. This is a much faster increase than the average globally, which is about 8 per cent. In many cases young women become infected through exploitative, coercive or violent sex.

“Linking HIV prevention efforts with reproductive health care can strengthen and improve access to both,” said Dr. Chaiyos Kunanusont, HIV/AIDS Adviser, UNFPA Country Technical Services Team in for Asia and the Pacific for the UNFPA, United Nations Population Fund. “Millions of women who don’t know their HIV status have an unmet need for effective contraception. Integrated services would enable them to protect themselves and also reduce HIV transmission to their children.”

The number of new infections amongst children and young people is also growing. In 2005, there was an estimated 8.3 million people, including 411,000 children living with HIV in Asia and Pacific, with 82,000 infected that year alone. About 90% of these children were infected as a result of mother to child transmission.

“Many countries in Asia and the Pacific already have national guidelines in place for the prevention of parent to child transmission. Many countries have trained health workers and are introducing treatment,” said Richard Bridle, UNICEF Deputy Regional Director for Asia and the Pacific. “The challenge remains how we better link these efforts to prevent disease and improve nutrition to provide a holistic package of services for mothers and their children.”

The meeting, from the 6 to the 10th November, brings together health professionals, Governments, people living with HIV, and civil society groups from 22 countries in the region. It has been jointly organized by WHO, UNICEF, UNFPA and UNAIDS. Delegates are expected to agree on a framework for stronger links between maternal and child health, family planning, sexual health and counseling and testing for HIV and sexually transmitted infections. They are also promoting a four-prong strategy for the prevention of primary HIV infection in mothers and young children. The first prong focuses on preventing parents-to-be from infection with HIV. Women are especially vulnerable to infection when pregnant and breastfeeding. The second prong seeks to assist HIV positive women and couples who want to avoid pregnancy. The third prong aims to ensure that HIV positive pregnant women are offered anti-HIV medicines, and other interventions, that lower the risk that HIV will pass to the baby. The fourth prong ensures that HIV positive mothers and their families have access to the care, support and treatment they need.

The meeting will also provide an opportunity for countries to share solutions and experiences. Experience from countries has already indicated that many of the services and initiatives needed to lessen the impact of the HIV epidemic will also help to promote the reproductive health of young people, and reduce the risk of maternal and newborn deaths.